Most health plans are missing key socioeconomic data required to develop meaningful population health management programs for vulnerable patients.

Source: Thinkstock

 By Jennifer Bresnick

March 07, 2017 - Managed care policymakers do not have access to enough clean, complete, and accurate socioeconomic and population health data on the millions of patients depending on public insurance programs for care, according to a new article in Health Affairs.

“To reduce disparities, it is critical to first know where they exist,” said the research team from CMS and NCQA.  “Improving documentation of race, ethnicity, and language needs in managed care plan reporting, regardless of data collection method, and clarifying how high-performing health plans achieve their results, will be important.”

EHR technology is one of many health IT systems necessary for success in adopting ACO models, a realization that has led to a new market for developers of end-to-end ACO solutions.

Source: Thinkstock

 By Kate Monica

March 06, 2017 - The lack of standardization in implementing accountable care organizations (ACOs) has created a demand for solution vendors capable of assisting healthcare organizations in seamlessly adopting these value-based care models.

A recent report from Chilmark Research evaluates the 10 leading ACO solution vendors for their capabilities and core competencies in providing a range of services for successful ACO adoption in an effort to help healthcare organizations make informed decisions about which vendor best suits their needs.

The population health management IT market is slated for significant expansion as providers look to improve interoperability and meet patient expectations.

Source: Thinkstock

 By Jennifer Bresnick

March 06, 2017 - Over the next five years, the population health management technology market is predicted to grow into a $42.54 billion opportunity, according to a Research and Markets report, but healthcare providers will need to adopt new care strategies at a similarly rapid pace if they are to make the best possible use of newly available data analytics tools.

As regulatory programs like MACRA and meaningful use, an aging population, and an increasingly complex chronic disease population continue to challenge the status quo of patient care, providers will need to focus on leveraging population health IT tools to optimize coordinated care delivery.

By Stephanie Zaremba  | February 3, 2017

A recap of the past two weeks of health policy news could be boiled down accordingly: ACA, ACA; does anyone have an ACA replacement plan?; ACA; Health and Human Services Secretary confirmation hearings; but seriously, what is happening with the ACA?

So you'd be forgiven if, while following the constant news updates, you forgot that 2017 brought not just a new president but also a new physician performance program: MACRA. In fact, in a live poll conducted during an athenahealth webinar about the ACA last month, a third of the more than 250 participants said they hadn't even heard of MACRA.

For the unacquainted, MACRA is the Medicare Access and CHIP Reauthorization Act of 2015. It is a significant law designed to reform the way Medicare pays physicians (though hospital inpatient payment is not impacted).

It creates a new Quality Payment Program, or QPP, by consolidating existing Medicare pay-for-performance programs: Meaningful Use, the Physician Quality Reporting System, and the Value-Based Modifier program. And it pushes clinicians toward participation in alternative payment models like accountable care organizations.

Population health rates and care quality levels vary significantly across the country, new data from the Commonwealth Fund shows.

 By Jennifer Bresnick

July 15, 2016 - Much of the nation gets a passing grade for care quality, access, and overall population health, according to new data from the Commonwealth Fund, but striking differences in performance, outcomes, and affordability of basic services persist between geographical regions.

Patients who live in the highest-performing areas of the country are up to thirteen times more likely to experience satisfactory care than those at the other end of the spectrum, the report said, and broad variations in insurance coverage rates persist even after the implementation of the Affordable Care Act.

“Many communities are showing signs of getting healthier, and that is encouraging,” said Commonwealth Fund President David Blumenthal, MD.  Nearly all communities included in the survey improved more often than they worsened, indicating overall positive progress towards healthier lives for patients.

Choosing the right big data analytics vendor is just as important as picking a great electronic health record, especially for accountable care organizations with value-based reimbursement on the line.

 By Jennifer Bresnick

June 09, 2016 - Selecting a vendor for an electronic health record, big data analytics system, or population health management tool can be a difficult process for a healthcare provider – and it only gets harder if that provider wants to participate in value-based care.

Accountable care organizations (ACOs) are founded on the ability to communicate with each other, coordinate services, and analyze the activities of their attributed patients. 

But since many ACOs are partnerships between providers and care sites that may not have worked closely together in the past, many ACOs find themselves juggling multiple technologies, varying levels of health IT sophistication, and vastly different vendors as they struggle to achieve their quality and revenue goals.

Accountable care organizations need to develop a robust population health management infrastructure to achieve savings and improve the quality of care.

 By Jennifer Bresnick

June 01, 2016 - Healthcare providers who wish to succeed as accountable care organizations have to address a lengthy checklist of tasks, strategies, and technologies long before they can hope to accrue shared savings from Medicare or a private payer. 

Developing the partnerships and population health management techniques to stratify patients, communicate effectively, meet demanding quality measures, and slash costs can be a difficult journey – and one that is nearly impossible without a robust health IT infrastructure to form a solid foundation of data-driven insights.

South East Michigan Accountable Care (SEMAC), a physician-owned participant in the Medicare Shared Savings Program (MSSP), has learned that data analytics and population health management technologies are a smart investment for success in the challenging environment of value-based care.

 By Kyle Murphy, PhD

September 16, 2015 - Despite significant interest in leveraging healthcare analytics, few healthcare organizations have the necessary strategy for blending financial, operational, clinical, and other data effectively, according to a recent Deloitte Center for Health Solutions survey.

Comprising responses from CIOs, CMIOs, and senior leaders from 50 health systems, the survey also finds healthcare data analytics adoption and spending falling short of industry predictions despite support for leveraging these emerging technologies for value-based care.

"As the shift from fee-for-service (FFS) payment models to VBC continues — including Medicare’s plans for increased value-based payments by 2018 — organizations will need to blend financial, operational, clinical, and other data to achieve their goals of improving quality, providing access, controlling cost, and managing provider networks," the report states. "A fragmented analytics strategy will not support effective integration of such data."

Overall, few health systems were capable of making use of healthcare analytics. According to Deloitte, less than half of respondents had a "clear, integrated analytics strategy"; one-quarter lacked an appropriate data governance model; one-third were unaware of their organization's spending on healthcare analytics; and one-fifth currently employed a decentralized model for healthcare analytics.